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Asthma and Bronchogenic cyst

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Hello,

I am a 42 year old female with a life time history of asthma. Two months ago I ended up in er due to a sharp pain in my right side just under my arm. Everything came back normal with the exception of a bronchogenic cyst that is less than 17mm and considered it to be water filled. I have had several chest xrays over the years and have never had this discovered. Information online about this cyst is sketchy at best and my doctor refered me to a thorasic surgeon who I was less than impressed with.

-What exactly is a bronchogenic cyst?

-Is there anyway estimating how long I have had it?

-Can this cause asthma flare ups?

-How do I make an informed decision about surgery?

-Do I even need to be concerned about this cyst?

Please help.


Category: Cardiothoracic Surgeon

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Category: Allergy and Immunologist
Dr. Jacob George Pulinilkunnathil is online now


Patient replied :

A) The location of the cyst is the posterior mediastinum (I have no clue as to where this is). I stand corrected on the size of the cyst, it is actually 17 mm in diameter and believed to be water dense.

B) I no longer have chest pain at this time and the doctor did not say one way or the other if the pain was attributed to the cyst.

C) I have have numerous chest X-rays in the past and have never had this brought up. The CT scan I had in June was my first scan ever done of the lungs.


Expert:  Dr. Jacob George Pulinilkunnathil replied 3 Days.

Hello,

Thank you for your reply clarifying my doubt. i do believe this is a bronchogenic cyst - details i mentioned earlier.

A cyst in the posterior mediastinum ( the central part in between your two lungs, behind your heart)will be missed on routine x rays and also difficult to pick up even if we look at the past x rays retrospectively. This cyst will be asymptomatic and will not be responsible to the pain you felt on the right side. It was an incidental finding, something like - looking for a mole, you got a mountain. However it is nothing to be worried of. the symptoms you had can not be attributed to the cyst. Hence it is still asymptomatic.

This can be safely ignored for the time being. Advising a follow up Ct after 6 months, and if no change in size, by end of 1 year and still no change in size / symptoms - by end of 2 years. After which it can be safely ignored.

Hope this helps.

Regards
Jacob George P


Dr. Jacob George Pulinilkunnathil
Category: Allergy and Immunologist
Experience: 
Residency, Post Graduation: MD, Respiratory Medicine, J L N Medical College, Ajmer, Rajasthan (2012).
Medical School, Internship: MBBS, Government Medical College, Kottayam, 2001-07 
Indian Diploma in Critical Care Medicine (IDCCM) - Medical Trust Hospital, 2013-2014.
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